小型节能头灯的制做与应用

医院(特别是儿童医院)在日常的诊断和治疗护理工作中,需要在小局部范围、短时间光源照明.目前市场上各种医用头灯存在着价格昂贵,使用不方便;我院医护人员在加05年10月至2007年3月使用我院自行研制的节能头灯,采用现代电子技术,在夜间给病人注射、换药和其他治疗以及查房巡视等小范围用光场合,取得了良好的效果.     

Cervicogenic exophthalmos: Possible etiology and pathogenesis

BACKGROUND Unilateral exophthalmos is often caused by inflammation, neoplasm, infection,metabolic disease, vascular disorder and several other less common conditions.Reflex sympathetic dystrophy related to unilateral exophthalmos has not been reported in the past literature.CASE SUMMARY We describe a 45-year-old female with unilateral exophthalmos caused by reflex sympathetic dystrophy and its unexpected spontaneous disappearance after a standard anterior cervical discectomy and fixation operation with two PEEK interbody cages and a plate. To our surprise, the patient’s left unilateral exophthalmos improved spontaneously in the morning on postoperative day 2-with no relapse, without any further medication, as of seven years. We have named this condition "cervicogenic exophthalmos."CONCLUSION We would inform other clinicians that unilateral exophthalmos was caused not only by inflammation, vascular disorder, infection, neoplasm, or metabolic disease, but also by reflex sympathetic dystrophy related with cervicogenic spondylosis. To the best of our knowledge, ours is the first related case report and use of the term "cervicogenic exophthalmos" after reviewing previous literature.     

Photodynamic therapy as salvage therapy for residual microscopic cancer after ultra-low anterior resection: A case report

BACKGROUND The rate of positive resection margins(R1) in patients with low rectal cancer is substantial. Recommended remedies such as extended resection or chemoradiotherapy have their own serious drawbacks. It has been reported that photodynamic therapy(PDT) as a remedial treatment for esophageal cancer.Colorectal cancer and esophageal cancer has many similarities,however,PDT as a salvage therapy for rectal cancer is rare.CASE SUMMARY Here,we describe a 56-year-old man who was admitted to the hospital due to a 6-mo history of hemafecia,which had been aggravated for 1 mo. Colonoscopy revealed a 3 × 4 cm ulcerated mass in the rectum 4 cm from the anus.Preoperative pathological examination showed villous adenoma,moderate-tohigh-grade dysplasia,good differentiation,and invasion of the mucosal muscle.The patient had R1 after ultra-low anterior resection,but he refused extended resection and experienced severe liver function impairment after 3 cycles of chemotherapy. Ultimately,the patient underwent PDT to remove R1. After five years of follow-up,there was no liver function impairment,recurrence,metastasis,sexual dysfunction,or abnormal defecation function.CONCLUSION This is the first case worldwide in which R1 of rectal cancer were successfully treated by PDT.     

Endodontic management of the maxillary first molars with two root canals: A case report and review of the literature

BACKGROUND The complex anatomy of the maxillary first molars has always been a major challenge for complete root canal treatment in endodontic therapy. Here, we present two cases of maxillary first molars, each with only two root canals, which have been rarely reported. We also perform a literature review of maxillary first molar anatomy.CASE SUMMARY The two patients were referred to the hospital after 1) finding a cavity in their tooth with a color change and, 2) a toothache during mastication, respectively.Both of these cases were diagnosed as apical periodontitis by X-ray imaging and cone beam computed tomography(CBCT). Non-surgical endodontic therapy was performed with the assistance of a dental operating microscope(DOM). CBCT showed rare but accurate images of both patients, each with two root canals and two roots in their maxillary first molars. Both roots were located in the buccal in the palatal direction, and each root had only one clear root canal. In addition,each maxillary first molar in both patients was symmetrical to that on the opposing side with only two separate root canals. Non-surgical endodontic therapy was performed with the assistance of a DOM. Finally, the teeth were restored using composite resin and the patients were satisfied with the results.CONCLUSION Making full use of CBCT and DOM would contribute to helping dentists make correct diagnoses and successfully treat teeth with rare root canal morphologies.     

世界疼痛日——中国镇痛周暨建立疼痛科新闻发布会隆重召开中华医学会疼痛学分会第七届年会胜利闭幕

世界疼痛日中国镇痛周暨建立疼痛科新闻发布会、中华医学会疼痛学分会第七届年会于2007年10月12～16日在北京九华山庄隆重举行.全国人大副委员长中科院韩启德院士、原全国人大副委员长中科院吴阶平院士、卫生部陈啸宏副部长、卫生部医政司王羽司长、卫生部科教司刘雁飞司长、中华医学会吴明江常务副会长、原卫生部副部长中国医师协会殷大奎会长及有关方面的领导、专家及参加大会的疼痛医学专家代表约五百人参加了新闻发布会.     

读片窗及答案

病例 男,62岁.以"发现尿黄5天"为主诉入院.无发热、恶心及厌食等伴随症状.查体:血压150/100mmHg,巩膜轻度黄染,腹软无压痛,肝区无叩击痛,肝肋下未触及.实验室检查:血WBC 13.1×109/L,EO 5.2×109/L,占39.7%.TBIL 36.6μmol/L,DBIL 21.5μmol/L,UDBIL 15.1μmol/L.ALT 88U/L,GGT 201U/L.AFP及CEA阴性.HBsAb阳性,其余4项均阴性.     

结合中医理论对上呼吸道感染的护理

上呼吸道感染一年四季均可发病,但以冬春季节为多.此类病人病程一般在10 d以上,易反复,有的甚至迁延不愈达1个月以上,造成门诊输液量增加、交叉感染机会增多,在医治过程中医护人员也易感染.此病虽然不像癌症使人恐惧,但它的发病率高,有的1年内可发病3次～5次,给身体和生活造成很大的不便.此类病人的症状为鼻塞、流涕、喷嚏、咳嗽、咽干、咽痛、头痛、发热、乏力、全身不适等,护理一般采取对症施护:休息、保持室内空气清新、多饮水、清淡饮食等,而应用中医理论施护则更具体、更有效,对于疾病的痊愈会有极大的促进作用.     

伸缩式垂直升降护理机的适用性探讨

昏迷病人、截瘫病人、慢性消耗性疾病及脑卒中后遗症病人常伴有肢体瘫痪而长期卧床,生活不能自理,大小便失禁,易发生压疮,给病人带来极大痛苦,给家属带来繁重的负担[1].为解决这一难题,人们研究了一些护理器械,如"升降护理装置",这种护理装置由铁床、软布带、支架杆、绑绳钢筋、软网布、定滑轮组件、动滑轮组件、万向节连接件和钢丝绳组成.     

Seroconversion of HBsAG coincides with hepatitis A superinfection: A case report

BACKGROUND Hepatitis B virus(HBV)is a hepatotropic virus that can cause acute and chronic liver damage.According to the world health organization 257 million people are infected with chronic HBV infection worldwide.Super-infection with other hepadnaviruses,including hepatitis A virus(HAV),hepatitis C virus,hepatitis D virus,and hepatitis E virus is associated with increased risk of acute liver failure in patients with chronic HBV.CASE SUMMARY Here,we report a case of a 47-year old male patient with HBV-related compensated Child A cirrhosis,who presented with general fatigue,malaise and laboratory signs of acute hepatitis.Although the patient was regularly seen at a specialized university liver unit,the HAV vaccination status was unclear.Acute HAV super-infection was diagnosed by positive serological and polymerase chain reaction analysis.Following acute HAV super-infection,spontaneous HBsAg elimination and development of an anti-HBs titer were observed.CONCLUSION This case illustrates the importance of carefully checking the vaccination status.In our patient,unspecific immunological responses to HAV led to functional cure of HBV.     

Combined surgical and interventional treatment of tandem carotid artery and middle cerebral artery embolus: A case report

BACKGROUND The 2018 American Heart Association/American Stroke Association guidelines for early management of acute ischemic stroke recommend the use of retrievable stents for mechanical thrombectomy in patients with acute internal carotid artery or middle cerebral artery M1 occlusion that can be treated within 6 h from onset.For cases of carotid artery with ipsilateral middle cerebral artery tandem embolization, the operation is more complicated and challenging. We here report a case of a tandem embolism, and the anatomy of the aortic arch was complex.Direct carotid artery incision and thrombectomy can not only prevent the escape of the carotid embolus but also save time during establishment of the thrombectomy access.CASE SUMMARY The patient was a 70-year-old man. He was admitted to hospital due to sudden inability to speak and inability to move his right limb for 3 h. Imaging confirmed a diagnosis of a tandem embolism in the left carotid artery with left M1 occlusion.Carotid artery incision thrombectomy combined with stent thrombectomy was performed. The operation was successful, and 24 h later the patient was conscious and mentally competent but had motor aphasia. His bilateral limb muscle strength level was 5, and his neurologic severity scores score was 2.CONCLUSION Carotid artery incision thrombectomy combined with stenting for carotid artery plus cerebral artery tandem embolization is clinically feasible. For patients with a complicated aortic arch and an extremely tortuous carotid artery, carotid artery incision can be chosen to establish the interventional path.     

头部围针对偏瘫的康复效果观察

目的探讨头部围针结合体针在偏瘫康复中的作用。方法90例患者分为头部围针体针结合康复组（实验组），焦氏头针体针结合康复组（对照组1），及康复组（对照组2）。判定标准为上田敏功能评价、日常生活活动能力（ADL）评定；头部围针组还进行汉密尔顿抑郁量表治疗前后评定。结果3组治疗前后功能评分有显著性差异，组间比较实验组ADL及下肢功能的恢复优于其他两组，上肢功能恢复无显著性差异。实验组治疗前后抑郁量表评分有显著性差异。结论头部围针是有效的疗法之一。     

供应室质量监测管理

供应室是控制院内感染的重点科室 ,其消毒灭菌效果直接影响着临床医疗质量和病人的安全 ,因此 ,做好消毒灭菌的监测管理 ,保证无菌物品的质量尤为重要[1] 。1　树立质量第一观念　　供应室是给临床、医技科室提供无菌医疗器材的单位 ,所供应的各种医疗用品直接用于病人 ,必须达到无菌、无热源的标准。由于工作性质决定了供应室工作人员必须树立全员性参与全流程控制质量的观念 ,发挥内在监控作用 ,使供应的每件医疗用品达到指定的标准。2　实施全方位质量监测　　按照供应室质量标准化要求 ,制订和完善各项规章制度、各班护士职责、各类工作…     

索他洛尔治疗心律失常疗效观察

应用索他洛尔治疗房、室性心律失常59例。用药前、后分别测血压、心率、心电图QTc、24小时动态心电图及肝、肾功能等血生化指标。结果房性心律失常者有效率为60%,室性心律失常者有效率为87.2%,总有效率78.0%。用药过程中仅有心率减慢、QTc延长及早期收缩压下降。索他洛尔治疗房、室性心律失常安全、有效,剂量以160mg/d为宜。     

多发性硬化MRI研究进展

磁共振检查在监测多发性硬化的病程进展和临床治疗中发挥着越来越重要的作用.近年来出现的磁共振新技术如磁共振波谱成像、扩散张量成像、磁化传递成像等为早期显示病灶和判断病理类型提供了新的视角.本文对近年来MRI在多发性硬化中的应用作一综述.     

康复疗养对高原官兵血液流变学指标影响的研究

目的：研究康复疗养对于高原官兵血液流变性的影响。方法将刚下4,000 m以上高原赴临潼疗养院的31名高原官兵分为疗养＋高压氧疗组和正常疗养组,分别于入院时、疗养15 d,疗养30 d检测血液流变学指标并进行统计分析。结果高原官兵全血高切黏度、全血中切黏度、血浆黏度、红细胞压积、全血高切还原黏度、全血中切还原黏度随着疗养时间的增加而降低,疗养＋高压氧疗组和正常疗养组疗养30 d、15 d较入院差异均有统计学意义（P＜0.05）,疗养＋高压氧疗组较正常疗养组效果好。结论刚下高原官兵通过康复疗养,血液黏度显著降低,对提高高原守防部队官兵的身体素质和健康水平,进一步增强部队连续作战能力有很大帮助。     

临床教学观摩竞赛体会

我院是一所综合性医院 ,实习生人数逐年增加。如何培养实用型护理人才 ,老师的教学能力是关键。为了增强教学意识 ,提高带教老师的讲学能力 ,扩大各临床专业之间的交流 ,我院举办了首届护理教学观摩竞赛。具体做法介绍如下。1　对象　　经过全院带教老师考核合格 ,有带教资格的注册带教老师 ,为参赛对象。2　方法2 .1　制定护理观摩教学竞赛活动方案2 .1.1　选手的选拔　在全院 2 94名注册带教老师中 ,首先以科室为单位 ,进行第一轮的选拔赛 ,注册带教老师在 15名以下的科室选送 1名 ,15名以上的科室选送 2名 ,在规定时间内将名单及讲课题目…